Surgical treatments including mastectomy and lumpectomy are applied to remove tumors from patients having breast cancer. Optimal outcomes require tumorous tissue to be surgically removed as completely as possible. To aid in removal of tumors, a radiologist may insert a clip in a breast duing biopsy to mark the tumor. A guide wire or multiple guide wires may be inserted into the breast to help the surgeon locate the targeted tumor during surgery. The clip can be used as a target for the wire.
To determine whether sufficient tissue has been removed, an excised specimen is examined to determine whether an adequate margin of cancer-free tissue is present at the surface of the specimen. Currently, a two-dimensional X-ray radiograph of a lumpectomy specimen is routinely used to evaluate the completeness of tumor removal. To obtain the radiograph, a tissue specimen is compressed between X-ray plates and imaged. The radiograph may be used to detect calcifications at the borders of the specimen. The radiograph can also be used to detect wires and/or clips to determine whether these markers were removed during surgery. However, as both wires and clips can move during surgery, detection of these lesion markers provides insufficient information for accurate assesment of whether sufficient tissue was removed. Further, the two-dimensional nature of X-ray radiography and the compression required impede accurate identification of which margins of the specimen are clear of cancerous tissue. Accordingly, after the operation is complete, the removed specimen is subjected to histopathology for a more accurate determination of whether sufficient tissue was removed during surgery. Histopathology results often require several days to obtain due to the time required for specimen logging, grossing, preservation, paraffinization, cutting, staining, and microscopic review. Histophathology demonstrates positive margins necessitating reoperation in approximately 20-40% of patients treated with lumpectomy. The need for breast cancer patients to undergo a second surgery (and, potentially, additional subsequent surgeries) creates significant emotional and financial stress.